Goal: Test the efficacy of a primary care-based brief intervention protocol in a sample of college students. Outcomes of interest include reductions in a) high-risk drinking; b) injuries, accidents and other health effects; c) high-risk sexual activity; d) unwanted sexual experiences; e) violence; f) contacts with dean of students office, university police and other legal agencies; and g) health care utilization events; as well as improved academic performance. Background: A 2001 national survey of colleges conducted by the Center for Alcohol Studies at the Harvard School of Public Health (Weschler, 2002) found that 44% of college students reported consuming five or more alcoholic drinks in a row at least once in the previous two weeks. Parents, college alumni, university leaders and others are increasingly concerned about the safety of young people on college campuses and the adverse effects of alcohol on the academic environment. While brief intervention studies have been conducted in many populations and settings, this method has not been tested in primary care college health centers. Method: Students will be asked to complete an embedded alcohol questionnaire at routine visits to a primary care provider at five student health centers in Wisconsin. Men and women who are enrolled as full time students who screen positive for high-risk drinking will be invited to participate in a health interview by a researcher. Students who meet eligibility criteria will be randomized to a "usual care" control group or a "brief intervention group". An intervention will be conducted by a primary care provider and utilizing a scripted workbook. Intervention will consist of two 15-20 minute provider visits and two 5-10 minute follow up phone calls. All subjects will be contacted at 6, 12, 18 and 24 months by telephone to assess changes in outcomes of interest. Additional sources of data include corroborative interview with a friend, university records, local hospital records and state legal records. Power analysis suggests 500 students in each arm of the trial will have sufficient power to detect a difference between groups. Significance: The proposed trial will significantly increase our understanding of how to reduce alcohol use and alcohol-related harm among college students. A positive trial would have important implications for the 4000 colleges and universities in the United States.